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Long Term Chronic Pseudomonas aeruginosa Airway Infection in Mice
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Inflammatory Phenotypes of Bronchiectasis.

Evangelia Koukaki1, Georgia Papaiakovou1, Argyri Klironomou1

  • 11st Respiratory Medicine Department of National and Kapodistrian University of Athens, Sotiria Chest Diseases Hospital, 11527 Athens, Greece.

Journal of Personalized Medicine
|October 28, 2025
PubMed
Summary
This summary is machine-generated.

Bronchiectasis exhibits diverse inflammatory profiles, not just neutrophil-driven. Identifying these phenotypes, like neutrophilic or eosinophilic, guides personalized treatments for better patient outcomes.

Keywords:
biomarkersbronchiectasisneutrophilic inflammationphenotypesprecision medicine

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Area of Science:

  • Pulmonary Medicine
  • Immunology
  • Respiratory Disease Research

Background:

  • Bronchiectasis is a complex chronic airway disease.
  • Traditionally considered neutrophil-driven, recent evidence highlights diverse inflammatory phenotypes.
  • These phenotypes impact clinical outcomes, prognosis, and treatment strategies.

Purpose of the Study:

  • To review and describe the distinct inflammatory phenotypes in bronchiectasis.
  • To explore the clinical implications and potential therapeutic targets for each phenotype.
  • To emphasize the shift towards personalized, biomarker-guided care in bronchiectasis management.

Main Methods:

  • A narrative review of scientific literature.
  • Structured literature search conducted on PubMed and Google Scholar.
  • Focus on identifying and characterizing inflammatory phenotypes based on cellular populations.

Main Results:

  • Four distinct phenotypes identified: neutrophilic, eosinophilic, mixed, and paucigranulocytic.
  • Neutrophilic phenotype linked to Pseudomonas infection, severe disease, and poor prognosis.
  • Eosinophilic phenotype associated with elevated eosinophils, FeNO, and potential response to corticosteroids/biologics.
  • Mixed and paucigranulocytic phenotypes present unique characteristics requiring further study.
  • Emerging targeted therapies include neutrophil protease inhibitors (e.g., brensocatib).

Conclusions:

  • Bronchiectasis presents a spectrum of inflammatory phenotypes with significant biological and clinical differences.
  • Understanding these phenotypes is crucial for developing personalized treatment strategies.
  • Transitioning to biomarker-guided care offers opportunities for precision medicine in bronchiectasis.